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99252 CPT Code: 2026 Billing Guide for Inpatient and Observation Consultations

CPT 99252 inpatient consultation billing 2026 hero banner: straightforward MDM or 35-minute time threshold, the first active level after 99251's 2023 deletion, Medicare's non-recognition requiring 99221-99223 instead, the 4-minute gap between 99252's 35-minute floor and 99221's 40-minute floor, and POS 21 versus POS 22 setting rules, from ClaimMax RCM.

The 99252 CPT code remains active in 2026. It reports an inpatient or observation consultation for a new or established patient, selected by straightforward medical decision making or by at least 35 minutes of total time on the encounter date. Traditional Medicare doesn’t reimburse the standard consultation codes, and commercial recognition changes by payer and product. […]